Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1100X | Ophthalmic | 35-03-0075 | OH |
NPI | 1205839453 |
---|---|
Provider Name | Dr. Thomas B Brumley |
First Address | Maumee, OH 43537-9383 |
Second Address | Maumee, OH 43537-9383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 13/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0202275 | (05) | OH |
A 35214 | (02) | OH |